FORM 1023-EZ for DIANE MARIE BROGAN FOUNDATION

Field Data
EIN 47-5638794
Case Number EO-2015357-000174
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DIANE MARIE BROGAN FOUNDATION
Organization’s Mailing Address 5255 LONGLEY LN STE 101
City RENO
State NV
ZIP 89511
Accounting period End 12
Primary contact name JAMES A KELLAMES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KELLE BROGAN MD
PRESIDENT
1865 ALEXANDER HAMILTON DR
RENO NV 89509

Officer/Director/Trustee Two

AMANDA CRAWFORD
SECRETARY
1865 ALEXANDER HAMILTON DR
RENO NV 89509

Officer/Director/Trustee Three

JAMES KELLAMES
TREASURER
5255 LONGLEY LN STE 101
RENO NV 89511

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/18/2015
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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